| Kootenai Family Dental Pllc | |
|
1420 Lincoln Way Ste 200 Coeur D Alene ID 83814-2360 | |
| (208) 664-8283 | |
| (208) 667-0794 |
| Full Name | Kootenai Family Dental Pllc |
|---|---|
| Speciality | Clinic/center - Dental |
| Location | 1420 Lincoln Way Ste 200, Coeur D Alene, Idaho |
| Authorized Official Name and Position | Alexis Larose (OWNER/DENTIST) |
| Authorized Official Contact | 2086648283 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Kootenai Family Dental Pllc 1420 Lincoln Way Ste 200 Coeur D Alene ID 83814-2360 Ph: (208) 664-8283 | Kootenai Family Dental Pllc 1420 Lincoln Way Ste 200 Coeur D Alene ID 83814-2360 Ph: (208) 664-8283 |
| NPI Number | 1063330892 |
|---|---|
| Provider Enumeration Date | 07/08/2026 |
| Last Update Date | 07/08/2026 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1063330892 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | (* (Not Available)) | Primary |
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